The changing face of orthostatic and neurocardiogenic syncope with age – Source: QJM, An International Journal of Medicine, Mar 7, 2011

[Note: syncope involves a dysregulation of the autonomic nervous system or heart abnormality where blood pressure & heart rate do not adjust normally to match the body’s changing requirements, and blood flow to the brain is reduced temporarily (as in rising to an upright position), causing ‘faintness’.]

Aim: Reports of the outcomes of syncope assessment across a broad spectrum of ages in a single population are scarce. It is our objective to chart the varying prevalence of orthostatic and neurocardiogenic syncope (NCS) as a patient ages.

Methods: This was a retrospective study. All consecutive patients referred to a tertiary referral syncope unit over a decade were included. Patients were referred with recurrent falls or orthostatic intolerance. Tilt tests and carotid sinus massage (CSM) were performed in accordance with best practice guidelines.

Results:
A total of 3,002 patients were included (1,451 short tilt, 127 active stand, 1,042 CSM and 382 prolonged tilt). Ages ranged from 11 to 91 years with a median (IQR) of 75 (62-81) years. There were 1,914 females; 1,088 males.

• Orthostatic hypotension (OH) was the most commonly observed abnormality (test positivity of 60.3%). Those with OH had a median (IQR) age of 78 (71-83) years. Symptomatic patients were significantly younger than asymptomatic (P=0.03).